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numbers. By this scheme all the schools in London were placed on a dental rota
and dental inspection of the children is carried out by the school dentists annually
for all age groups of children except those due for examination during the year by
the school doctors.
Circumstances have prevented the consequent increase of treatment provision
at the rate that was then expected.
Between 1921 and 1925 the dental inspections have increased from 151,395 to
262,482—that is, 73 per cent.
Provision for dental treatment under the Council's scheme in the same time
has been increased from 94,177 to 112,964 cases—that is, 20 per cent. The result
has been that although more dental work has been done, the percentage of those
treated to those found needing treatment has fallen. This, however, is entirely due
to the increased inspections carried out, and is not a real reduction. In fact, there
has been a steady increase in the number of children treated.
Owing to necessarily slow growth of dental provision, due to the financial
situation, the present position is that many of the dental centres are congested
with patients, bookings are made long ahead, and the dental inspections not being
adjusted to treatment requirements, in many centres the congestion is progressive,
and the work is greatly hampered.
Formerly it was possible partly to hold up inspections at a particular centre
which was congested until arrears of treatment were overtaken, inspection sessions
being converted into treatment sessions at need. Under the rigid application of
the present scheme, this was not possible: freedom of action in this matter is now
restored so that inspection sessions may be converted into treatment sessions when
found necessary.
Many more children will thus be treated, while the general result, so far as
inspection is concerned, will be that, temporarily, in some schools the children will be
inspected at 15 to 18 monthly intervals, instead of at intervals of one year.
Children absent from School for long periods.
The attendance officers supply each month a list of the children in their districts
who have been absent from school for a period of three months and upwards. Inquiry
is made into the adequacy of the treatment the cases are receiving and from time to
time special examinations are made to ensure that every effort is being made to
secure proper treatment or to ascertain whether special education is advisable.
During the month of November, 2,398 children were on the list, several suffering
from two or more complaints. The following table gives details for the last four
years.
It will be seen that the rheumatic group of cases accounts for one fourth of the
chronic invalidity amongst school children and rheumatism is by far the most
important single cause for prolonged illness in children.
The age distribution of these cases shows that prolonged absence from school
occurs most frequently at age 5-6 largely due to the after effects of measles and
scarlet fever, and again at age 12-13 when the incidence of heart disease, rheumatism
and chorea is heavier. At ages 10-14 more than twice as many girls as boys are
absent from these causes. There is also a large preponderance of older girls absent
from anaemia and pulmonary tuberculosis though boys suffer more often from other
forms of tuberculosis.
X-ray treatment of ringworm renders long absence from this cause less common
than in previous years. There were 85 absences in November, 1924, and 81 in 1925,
compared with 234 in 1913 and 178 in 1914. Not only are there fewer cases but the
period of absence is so much shorter that few of the cases remain out of school as
long as three months.